Active NPI
Jerry Alan Bates, M.D.
- Neurology Physician
- Rockwall, TX
National Provider Identifier
1710034095
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Neurology Physician
- License
- 300857
- Practice address
- 714 Calm Crest Dr
Rockwall, TX 75087-6454 - Phone
- (972) 974-2952
- NPI assigned
- Jan 5, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 01063076A | IN | |
| Student in an Organized Health Care Education/Training Program | 390200000X | 01063076A | IN | |
| Neurology Physician | 2084N0400X | 01063076A | IN | |
| Neurology Physician | 2084N0400X | 300857 | LA | Primary |
Addresses
Primary practice location
714 Calm Crest Dr
Rockwall, TX 75087-6454
Mailing address
714 Calm Crest Dr
Rockwall, TX 75087-6454
Phone (972) 974-2952
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01063076A | Other | IN | PHYSICIAN LICENSE |
| 300857 | Other | LA | LOUISIANA PHYSICIAN LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01063076A | IN | MD | Internal Medicine Physician |
| 300857 | LA | MD | Neurology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167955200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1453852800000",
"number": "1710034095",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "714 CALM CREST DR",
"city": "ROCKWALL",
"state": "TX",
"postal_code": "750876454",
"telephone_number": "972-974-2952"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "714 CALM CREST DR",
"city": "ROCKWALL",
"state": "TX",
"postal_code": "750876454",
"telephone_number": "972-974-2952"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BATES",
"first_name": "JERRY",
"middle_name": "ALAN",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-05",
"last_updated": "2016-01-27",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "IN",
"license": "01063076A",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "IN",
"license": "01063076A",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "IN",
"license": "01063076A",
"primary": false
},
{
"code": "2084N0400X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Neurology",
"state": "LA",
"license": "300857",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHYSICIAN LICENSE",
"identifier": "01063076A",
"state": "IN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LOUISIANA PHYSICIAN LICENSE",
"identifier": "300857",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Rockwall, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.